Professor Dame Sally Davies is England’s Chief Medical Officer (CMO), and Chief Medical Advisor to the UK government. She also has particular responsibilities regarding public health. In her tenth annual report as CMO, she considered what the public’s health in England in 2040 could look like. We spoke to her about the report’s key recommendations and her hopes for the future health of the nation. 

Your annual report included a strong focus on ‘health as one of the primary assets of our nation’. What made you focus on that theme and why do you think it’s important?

I think we need to reframe how we look at health. It is often perceived as a cost to the public but we must reposition health as an investment. If employers invest in their staff’s health, productivity will increase, sick days will reduce and the economy will grow. Investing in health is a win for everyone.

Why did you focus a chapter on the local health environment, and what do you think are the key take-aways from this that you would like to see action on?

The Health Foundation has done several important impactful pieces of work on the health environment and place-based public health. I invited them to contribute a chapter to our 2018 annual report because I wanted them to paint a picture of what ‘success’ would look like and what it would mean for our health at a local, community level. This will be of increasing importance with devolution in years to come.

This chapter helped inform my recommendations, specifically regarding the density of fast food outlets near schools and links to obesity and, given the inequalities across communities, the role that the built environment could play in tackling these inequalities.

The Health Foundation highlighted that local coordinated action across the community can and must play an important contribution to improving the health of individuals and society. The chapter also emphasised that health is an asset to our nation, communities and individuals and we must treat it as such: promote and preserve good health.

The first recommendation in your annual report calls for the creation of a Health Index for England. Do you have any updates on how that recommendation has been taken forward, what it might look like and what this was influenced by?

The recommendation of a Composite Health Index has stimulated a discussion within government and I hope we will hear more about it soon. I believe we need to consider the wider determinants of health more and look at these next to risk factors and health outcomes. There is currently lots of data but we need to bring it together for a more accurate view of what is happening nationally and, importantly, then we need to be able to disaggregate so we can see the local variations and act on it.

You are due to leave your position as Chief Medical Officer soon. In your time as CMO, what do you feel has made the biggest contribution to ensuring people in the UK can lead healthier lives?

There are many things I feel proud about, it has been a very fulfilling and busy job. Some of the public health policy interventions, such as plain packaging cigarettes, the Soft Drinks Industry Levy and two childhood obesity plans have been very welcome. Overall though, I feel most proud about the UK action on and the international momentum generated behind the antimicrobial resistance agenda. It is an incredibly complex issue that requires an international one health response. I played a role in generating that momentum and was a Co-Convenor of the United Nations Interagency Group on Antimicrobial Resistance tasked with identifying the solutions.

Looking ahead and thinking about the issues that will face your successor, where are the biggest opportunities to improve the population’s health, and what do you think are the biggest barriers to ensuring that health is prioritised as a national asset?

I think sustained work on social determinants generally and childhood obesity particularly are issues that cannot be fixed overnight and need political will. I think vaccinations rates need to improve, we need to see a continued decline in smoking rates and dramatically reduce air pollution.

Health needs to be seen our primary asset. It needs stakeholders to reinforce this politically palatable message regularly and for policy makers to harness it. For it to be truly effective, we need all government departments thinking about health.

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.

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